Basic Information
| Provider Information | |||||||||
| NPI: | 1578869020 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARAMOUNT MEDICAL CARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 434 E 5350 S | ||||||||
| Address2: | SUITE B | ||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844056931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014757100 | ||||||||
| FaxNumber: | 8014757101 | ||||||||
| Practice Location | |||||||||
| Address1: | 434 E 5350 S | ||||||||
| Address2: | SUITE B | ||||||||
| City: | OGDEN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 844056931 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014757100 | ||||||||
| FaxNumber: | 8014757101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2011 | ||||||||
| LastUpdateDate: | 03/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | JENKINS | ||||||||
| AuthorizedOfficialFirstName: | LINDSI | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8014757100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0005X | 5285165-1204 | UT | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine | 207Q00000X | 5285165-1204 | UT | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.